“Despite improvements in the perioperative care of patients undergoing pancreatic surgery, the risk of major complications including anastomotic leak (6–24%), post-operative pancreatic fistula (POPF) (10–40%) and delayed gastric emptying (20–34%) persist. Post-pancreatectomy haemorrhage (PPH) is a less common, but particularly hazardous complication with mortality rates of up to 40%. However, varying definitions and incidences of PPH have been previously reported, which have hindered comparison of optimal treatment modalities.”

“This is the largest systematic review to date evaluating outcomes from PPH and also the first to stratify management and successvrates by ISGPS grade of PPH. Despite this, case numbers per grade and modality are low. Variation in interpretation of ISGPS definitions in combination with difficulties in ascribing physiologically dynamic parameters to strict classification, mean that caution must be exercised when interpreting these data. Such
heterogeneity of definitions and outcome reporting makes synthesis of data difficult and prevented meta-analysis.”

Maccabe, Thomas A et al. “A systematic review of post-pancreatectomy haemorrhage management stratified according to ISGPS grading.” HPB : the official journal of the International Hepato Pancreato Biliary Association vol. 24,7 (2022): 1110-1118. Free Full Text